In a nutritionally-perfect world, most of our meals would consist of fresh, sustainably produced vegetables, fruits, meat and fish.  We would prepare them in our own kitchens with as little added fat, salt, and sugar as possible. Processed foods, which usually contain higher-than-necessary levels of sugar, salt, saturated fats, and even chemical preservatives, would hardly ever show up in our diets.  But achieving this world is quite a challenge in this day and age for many reasons.  Busy families with working parents do not have time to cook, and so rely on prepared foods. Low-income people, often cannot find or afford fresh fruit, vegetables, and meats. And our innate love of sweet, salty, and fatty foods keeps us coming back to those processed foods which are designed to hook us.

Until such time as everyone can have access to, and afford good, wholesome food, and we can curb our sweet tooth when temptation is all around us, the next best thing is to reformulate the processed foods we do eat to make them healthier. Reformulation can save lives. A French study estimated that deaths from nutrition-related diseases could be reduced by 5 percent—thousands of lives per year—with much greater benefits among low-income people, if processed foods were reformulated.  But reformulation can also be tricky: companies must lower the amount of sugar, salt, fat, and calories in processed foods without compromising taste, “mouth feel,” shelf life, and other attributes that ensure consumers will continue to buy their products. This is not always considered possible to achieve.

Processed food reformulation has been underway to a certain degree, around the world, for many years—sometimes voluntarily on the part of food and beverage manufacturers in response to changing consumer preferences or threats of regulation, and sometimes as a result of government mandates. Advocates must be persistent and aggressive in demanding changes to drive both voluntary and regulatory strategies. The process may be slow, but it can be successful:

• 20 years of advocacy resulted in getting artificial trans fats out of most processed foods in the US. See this Center for Science in the Public Interest timeline on the process. More recently, the WHO called for elimination of all industrially-produced trans-fats from the food supply.
• In 2009, the New York City Health Department launched its National Salt Reduction Initiative, a coordinated partnership of 100 city and state health authorities and health organizations that worked with industry to voluntarily reduce sodium in packaged and restaurant foods by 25% over 5 years. The Department reported in 2016 that sodium levels in top selling packaged foods decreased by about 7%.
• The United Kingdom, published salt reduction targets in 2004, and reported a reduction in population salt intake by 11% between 2005-14. The National Institute for Health and Care Excellence estimated that the initiative could prevent around 18,000 strokes and heart attacks, and save around £1.5 billion in health care costs per year in the U.K.

What does it take for the food and beverage industry to reformulate?

It takes science, education, advocacy, and consumer demand.  It takes a willingness on the part of industry to work with government and advocates to make changes. And if all else fails, it takes government regulation.

Thanks to scientific research on the negative health effects of consuming too much added sugar, salt, and fat, and to public health education campaigns, more consumers than ever are aware of the negative health effects of consuming too much of these ingredients.  As a result, advocates and the general public are demanding healthier products. Companies are responding. Soda manufacturers are offering more products with less sugar. Even candy companies are reformulating their treats: Nestle announced in 2018 that it will reduce by 30% the amount of sugar in some of its bars.

At the same time, governments can incentivize the food and beverage industry to reformulate. They can start with frameworks for voluntary improvements, and if that approach fails, they can spur progress by setting targets for reducing consumption across the population, setting product category reformulation targets, and engaging companies in voluntary efforts. Lastly, government could set mandatory targets if the companies fail to reach the targets with voluntary efforts.   Read more on this subject here.

Focus on Sugar

Why Lower it in Processed Foods?
Humans are naturally drawn to sweet tastes, and the processed foods available to us in the United States are engineered to satisfy our desire for sweetness. About three out of every four (74 percent) of all processed foods contain sugar, which is added even when it’s not necessary, for example, in peanut butter or canned soups.  In other products, such as granola bars, cereals, or sodas, the amount of sugar added is often far beyond what is needed to make the product palatable, and results in more calories as well.

For many people, it’s difficult to make the conscious choice to avoid eating sugar. Because so many people rely on processed foods, reformulation can improve our diets without us having to make that choice. 

Government-Industry Voluntary Agreements to Reduce Sugar

Governments around the world are encouraging industry to make public commitments to reduce sugar and other nutrients of concern in its products. Here are just a few examples:

United Kingdom
Public Health England (the government’s public health department):

• published technical guidelines for how the food industry can reduce sugar by 20% (by 2020) in 9 food groups;
• is calling on food manufacturers to cut calories by 20% before 2024.

France
Since 2008, thirty-seven food manufacturers and retailers have signed the government’s Charters of Voluntary Engagement to reduce sugar and other unhealthful ingredients in their products.  The WHO reports that a typical commitment would be to decrease sugar by 3.8 - 15%. Based on the first 15 signed charters, up to 13,000 tons of sugar were removed from the French food market between 2008–2010.

Spain
In 2018, Spain announced plans with 500 companies to reduce sugar, salt, and fat by about 10% in over 3500 food and drink products.

Other Ways to Encourage Industry to Reformulate

Food labels
In May of 2016, the Food and Drug Administration published new regulations to update the Nutrition Facts Label, which include changing how the sugar content is shown.  The current label shows naturally-occurring and added sugars together; the new label will separate the two, on different lines. And with the new label, serving sizes will reflect more realistically what people actually eat or drink.  For example, a 20-ounce soda which has been labeled as 2 servings will become one, given that people usually consume all 20 ounces in one sitting.  There are other changes as well, with the overall goal to make it easier for people to figure out how much sugar (or salt, or fat) is in the product and what proportion of our daily recommended intake it represents, and to make it easier to keep track of how much we’ve consumed during the day. To the dismay of advocates the FDA announced in May of 2018 that they will delay the implementation of the new label for 18 months. 

In addition to the Nutrition Facts Label, a front-of-package label in a simple, graphic, color-coded format would make it even easier for consumers see how much sugar, salt, fat, and calories are in a product they may want to buy.  This example from Chile, which passed a law in 2016 to require front-of-pack labels, makes it clear that the product is high (“alto”) in sugar, fat, calories, and salt.

Those labels led manufacturers to reformulate 25% of foods to avoid “high in” labels. Ecuador and Bolivia have similar labeling laws. The U.S. does not, but a label on food products here could look like this one, from the British Nutrition Foundation:

Menu Labeling 
In May, 2018, a U.S. menu labeling law went into full effect.  This means that consumers will be able to see on menus how many calories are in the food they buy in chain restaurants and movie theaters, and in the prepared food they buy in supermarkets and convenience stores (with 20 or more outlets). They will also have access to information about how much salt, fat, and sugar are in those foods. A recent systematic review of the effect of menu labeling in restaurants showed modest reductions in calories purchased. In part, this may be due to greater availability of reformulated, lower calorie products. Now that menu labeling will be implemented nation-wide, more studies are needed to gauge whether the industry will respond by lowering amounts of calories, fat, salt, and sugar, in more of their offerings and whether customers will consume less.

Marketing Restrictions
Restricting the marketing of nutritionally-poor products, especially to children, is an ongoing goal of public health advocates. Regulations that prohibit (or guidelines that strongly suggest ending) the marketing of products that fail to meet certain nutrition standards have the potential to provide an incentive for reformulation, but can also have unintended negative consequences. For example, in 2014 the USDA established “Smart Snack” standards for snacks, such as Cheetos, Fruit Rollups, and Pop Tarts, that are sold in schools. While the food companies did in fact reformulate their products to meet the standards, they packaged them to look similar to the less nutritious versions still sold in stores. A Rudd Center study suggested that selling these “look-alike” products could lead parents and children to assume that the brands sold in store meet the same nutrition standards, and continues to allow the companies to market their brands to children in schools.

Resources on Food Product Reformulation

• Access to Nutrition Index assesses and ranks the world’s largest manufacturers on their nutrition-related commitments, practices and performances.
• World Health Organization’s (WHO) recent (2017) report on reducing sugar content of manufactured foods.
• WHO Policy Brief on Producing and Promoting More Food Products Consistent with a Healthy Diet, 2014.
• WHO guidance on ending the inappropriate promotion of foods for infants and young children, 2017.

Written by Roberta Friedman